It had been another one of those weeks ~ the ones with some hardness, some laughter, some unique challenges and the exquisitely beautiful reminders of our intimate connectedness to all of it. My daughter, Shelby, who also worked at the Cancer Center some of the years that I did, was reading a Brene Brown’s book and shared a quote with me as I came into work on the final day of a week that had held multiple losses and staff shortages. 

“Feelings are not facts”, she said. Now, mind you, I was entirely unfamiliar with the context from which this quote came and unaware of where Brene was headed with it but it made me feel like it could be interpreted to mean our feelings are not legitimate. Maybe what she meant was that when we feel something, it is usually fluid; meaning, it changes. However, in the moment we are feeling it, it sure feels like fact. In grief work one assurance I will eventually offer a client is that your feelings will shift. That feeling of being lost in the darkness of devastation, walking through quicksand underwater and barely able to breathe, will, at some point, soften and become more manageable. But, initially, in the early shock of even an expected loss, whatever we are feeling is our reality and many of us feel it with our entire being. I have said this before, and I will continue to say it, the experience of your life as a staff person within the walls of any Cancer Center is not something very many people can begin to understand. 

When there is too much sorrow in any one day or if it accumulates too quickly over many days we need to have a way to “Stop the Line” and breathe. 

But we don't. 

We need to be able to ‘fall apart’, ‘come undone’ and just be in our feelings.

But we can't.

Yes, our feelings are not facts, but they sometimes demand our attention in a very real way and in the work of treating cancer, it’s crucial that we somehow find a way to allow for it within the small sub-tribes of various teams and that we offer non-judgmental refuge for it to one another. 

This particular week the inner sanctum of Medical Oncology had felt like a Nascar pit. My office was within those walls; and my door was almost always open. So I was often an observer of the way that particular department of our center worked; the way the nursing staff and ancillary clinical staff choreographed the dance of treating sometimes as many as 25 patients a day with just 6 chairs and 4 private rooms. On this day, we had two skilled, experienced nurses managing the chemo infusions along with one MA taking vitals and weights as patients checked in. Those three were the immediate Pit Crew. 

But what I watched happened on this Friday was that everyone else who could, stepped in to do whatever they could, to get our patients treated as seamlessly and expeditiously as safely possible. That was how they provided the refuge for one another. They brought food down for staff to grab bites of, they took warm blankets to patients and carried food trays to them when lunch arrived. They got water and coffee for family members accompanying patients. They answered phones and took messages. They ran blood to the lab. And they did it all with smiles, with grace and with love.

I know it meant, for some of them, that they were unable to do their normal jobs; and for others that they were leaving providers without the support staff they normally had. It meant some of the staff would then work longer hours than normal for many days but we did it and that day when our last patient was walked out to the lobby we lowered the checkered flag, rolled off the track, cooled our engines and celebrated a week long race that was accident free. I don't think, unless they were told by someone on the team, that any patient even realized the strain the staff was under that week. 

We had experienced a string of deaths with no time between them to process. The yellow inter-office envelopes that held condolence cards for families ; the ones that circulated to all the cancer center staff to sign whenever a patient died, were stacking up like crazy on the corner of my desk. Wherever I walked they were sitting alongside desks waiting for a signature or a note from any one of a dozen people who had been part of the care team for that patient during treatment.

I always felt a little helpless in times like those when patients were rapidly needing things only the nurses could provide; when I could see the strain on their faces and the tears just behind their eyes. Nurses, who on this day, the final day of a week that could be appropriately described as emotionally brutal, were so close to the edge of breaking; the grief of losing so many patients so close together, people they had cared for and loved, seeping from their pores.

Providers in a cancer center are so often trying to solve the unsolvable, fix the unfixable, manage the unmanageable and control the uncontrollable that stress becomes a constant state in many of their lives. The problem is not so much that they direct countless amounts of compassion to their patients, and to one another, but that they often fail to direct enough, or any, of it toward themselves. 

They take on impossible tasks and then feel like a failure when they cannot deliver. I often saw us, when I was one among them, as traumatized individuals working with a traumatized population. Compassion, compassion that flows both ways, is one way we can reconstruct ourselves when we feel the effects of deconstruction. Compassion that flows both ways is how we can regain a sense of footing in a world that throws us off balance. Compassion that flows both ways is how we can recalibrate our equilibrium when our ship starts to list. It has to flow both ways, not just from us to others. Part of our very nature as humans is to offer compassion to someone who hurts; to be an empathetic witness to a situation we know can't fix. 

There is no situation where offering compassion is wrong.

This story is from a time, pre-pandemic. A time before anyone knew what could actually be asked of a staff within the confines of any medical institution. A time before hospital staff would be asked to watch patients die every day, asked to watch families being denied access to them, to watch the rapid unraveling of our country's infrastructure while everyone was dancing as fast as possible to keep the sky from falling. 

I'm unsure how much I will try to say about the past 3 years on this website. It will come up on occasion I'm sure, but I think we still need more time to unwrap that ball of yarn; to begin to identify all the various forms the trauma of this pandemic is taking and will take. I already get glimpses when I hear snippets of the evening news. And to add insult to injury, it seems as if there are daily reports of natural disasters ravaging the planet coming right on the tails of the pandemic. As I pull stories from the bowels of my computer and set about editing them I harken back to those times; the ones that in the moment may have felt close to unmanageable but that we now know were anything but.

Thank you for spending this time with me. I hope you'll join me again, Where the Veil Grows Thin.